Shifting U.S. global health policy to provide international development assistance for cancer control in low- and middle-income countries (#591)

The
U.S. is a major contributor to international development assistance.1 Its policies
drive global health initiatives in countries receiving funding. Given limited
resources to address the global cancer burden, advocates must identify
opportunities to leverage existing funds and platforms.

Aim:

LIVESTRONG Foundation lobbied Congress members and government staff to develop legislation or
operational guidance enabling greater flexibility of existing U.S. global
health investments. By linking current global health priorities to cancer, more
interventions could be put in place to tackle emerging NCDs.

Strategy/Tactics:

LIVESTRONG was one of fewer than 20
organizations invited to deliver testimony to members of Congress
regarding the allocation of FY15 global health funds. We stressed U.S.
investments should address the current global disease burden, and offered
examples of linkages between cancer and communicable-disease priorities with substantial
budgets. Later, we sponsored a delegation of congressional staff to travel and
observe programs in sub-Saharan Africa that demonstrate the connection between
cancer and other global health priorities. Finally, we pushed for new
legislation of the U.S. PEPFAR program to include language linking HIV/AIDS and
cancer.

Programme/Policy Process:

It
was important to identify components of global health legislation or funding
that could be related to cancer control, and moments in the congressional
calendar when those would be debated. An ongoing contentious political context
in the U.S. altered our standard advocacy process and timeline. Updates to
PEPFAR legislation were particularly cumbersome due to conservative
interpretations and stakeholders. Lobbying activities required a high degree of
flexibility, ingenuity, and clandestine efforts to be successful.

Outcomes/What was learned:

A
multi-pronged strategy was required to challenge the status quo, and
field-based case studies were essential. We were successful in fostering
unlikely champions to highlight best practices and updating PEPFAR legislation
to include cancer. Our approach is applicable to advocacy in both donor and
recipient countries.

Institute for Health Metrics and Evaluation. Financing Global Health 2013: Transition in an Age of Austerity. Seattle, WA: IHME, 2014.